REVEALING GENES
Drs. Lisa Shaffer and Bassem Bejjani know how to deal with a problem. They take it and break it down into smaller pieces. Very small pieces. Put it this way: The view through a microscope was too big.
Their company, Signature Genomics, now does diagnostic testing for chromosomal abnormalities — gains and losses in the genome that result in developmental disabilities such as autism, epilepsy and Down Syndrome.
“We test children for these developmental disabilities, and we also do prenatal testing. We can look for gains and losses of the DNA prior to a baby being born,” Shaffer says.
Shaffer and Bejjani have pioneered the use of the microarray for such genetic testing, a cutting-edge tool that allows genes to be analyzed at a DNA level impossible to reach by simply looking through a microscope.
Before microarrays, genomes were tested via chromosomal analysis, a method that involved comparing normal genes to a patient’s genes under a microscope.
“[Microarray] testing in children has almost completely replaced the older testing method … looking through a microscope, you couldn’t see all the things we can see at the DNA level,” Shaffer explains.
Bejjani, she says, equates the two methods to looking at an encyclopedia collection. With a microscope, they could tell if a volume or a cover was missing. With microarrays, they know if a page or even a paragraph is different.
“I started using microarrays in my research lab,” Shaffer says. At the time, Shaffer was the technical director and Bejjani was the medical director at the cytogenetics lab at Baylor College of Medicine in Houston, Texas.
“Bassem and I got to talking about why this [microarray technique] wasn’t being used clinically,” Shaffer says. The duo brought the idea up to the college, but Baylor College of Medicine shot them down. “They said there were too many hurdles.”
But Shaffer and Bejjani wouldn’t take no for an answer. They moved to Spokane and started their own company, Signature Genomics. Now with more than 100 employees, they’ve tested more than 40,000 children internationally, Shaffer reports.
“High-resolution testing has completely changed the way we look at trying to diagnose birth defects and has given us new reasons why [children] have developmental diseases,”
But identifying problems is only part of the goal at Signature Genomics. Ultimately, Shaffer hopes that the testing that the company is doing today might pave the way for treatment in the future.
FIXING FRACTURES
Dr. George Bagby, a Spokane orthopedic surgeon, is a hero for humans and animals alike. He was first introduced to medicine through his stepfather, Dr. Jared Burton, a veterinarian from Minnesota.
“He gave me my first interest in medicine. I’d stand there and watch him. He talked me through my first surgery — how to cut a dog’s tail off. I was so concerned about doing it right I ended up freezing my hands [with the sterilizing alcohol],” Bagby laughs.
“I was just about ready to go into [pre-veterinary medicine] when Pearl Harbor happened, and I decided that they could use me more as a medical doctor than as a veterinarian. The military paid my way through medical school, and — can you believe it? — just six months before I graduated, the war was over with, so I graduated a civilian.”
Bagby got his chance to serve in the Korean War, where he worked as an orthopedic surgeon. “The military came along and asked me, ‘How long have you been in training?’ And I said, ‘Three months.’ Well, they mistranslated it and put it down as three years, so that’s why I got sent out to [Korea] to do surgery. After the war I went back to the Mayo Clinic and completed my training.”
While in Korea, it was necessary for Bagby and other doctors to put wounded soldiers into traction, a process that, while it holds broken bones in place, does not proactively press them together. The doctors knew the procedure didn’t optimize healing, Bagby says, but it was the only method available. A chance encounter with a sagging screen door changed that.
“When I got back to Rochester [Minn.], the back screen door was sagging. So I got an angled plate and started to put the screws in to get the door back into place, and I accidentally put in a screw that was off-set, and I noticed the wood moving laterally to where the metal was, and that was my inspiration for my self-compressing bone plate.”
A self-compressing bone plate pushes the ends of a broken bone together, a process that is easier on bones and has a faster healing time.
Washington State University veterinarian Dr. Barrie Grant heard of Bagby’s invention, which could be used in dog femurs as well as in humans, and asked Bagby to come down to WSU and help him with other animal medical problems. One of these problems was a horse with Wobblers Syndrome, partial hindquarter paralysis brought on by a cervical spine compression.
“At the time, I was doing a Cloward Procedure on humans,” says Bagby, which involves cutting a hole in the spinal disk and then inserting a bone dowel, cut from the patient’s hip, into the hole. However, horses are not like humans, and Bagby needed a way to insert a dowel into the spine without doing a secondary procedure on the horse’s hip. So he invented the Bagby Bone Basket, or BBB — a steel dowel capped at both ends.
“The basket was exactly the same as the dowel, except it was hollow, and had holes in the sides of it,” Bagby says. “It was just as good as the Cloward Procedure, but with less surgical trauma.”
The BBB was improved upon in 2000, when the famous racehorse Seattle Slew came down with Wobblers Syndrome. The Kerf Cut Cylinder, Bagby’s new version of the BBB, was inserted into Seattle Slew’s spine. The Kerf Cut Cylinder, also called the KCC or Seattle Slew Basket, was similar to the BBB, except that the KCC was not capped off, allowing the bone to build back around the outside and inside of the basket. “The whole purpose of the Kerf Cut Cylinder, or Seattle Slew Basket, is not only to have a bone graft [in there], but a living bone graft,” Bagby explains. Within a year and a half after the surgery, Seattle Slew had found his feet and was back in the breeding barn.
Both the self-compressing bone plate and the baskets have been used internationally, Bagby reports. He himself has done the wobblers surgery in Saudi Arabia, France and Germany. And the concept eventually was adapted by other surgeons into a cage for use in humans.
Nowadays, Bagby’s main interest is in the hospital that he and orthopedic surgeon colleague Dr. Ruhal Haque started in Nalta, Bangladesh, in 2000. Serving approximately a 35-mile radius, the hospital is still, Bagby says, “a long, long way” for patients to travel. The hospital offers general services but specializes in orthopedics and cataract surgery.
ONE BREATH AT A TIME
Sometimes life can take your breath away. Luckily, Dr. Forrest Bird is there to give it back. A World War II pilot, Bird helped pilots gain new heights with the invention of his first respirator, an Aircrew Breathing Regulator.
Prior to Bird’s invention, lack of oxygen limited pilots to flying below 28,000 feet. Upon demonstrating a prototype of his Aircrew Breathing Regulator to Dr. Harry G. Armstrong at the Army School of Aviation Medicine at Randolph Field in San Antonio, Texas, Armstrong “remarked that either I was a damn fool or I knew something he did not,” Bird says. “My reply was, ‘Probably a little bit of both, sir.’”
Bird’s invention went on to be used by the military, preventing pilots from becoming hypoxic at altitudes above 35,000 feet.
While Bird recovered from an injury that took him off flight status during the war, he studied medicine. At that time, he says, he didn’t want to “hang up a shingle and practice medicine,” but just “wanted to learn medicine and have the same education as a physician.”
After the war, the condition of a friend’s father, diagnosed with emphysema, motivated Bird to invent his first commercial respirator, put together with a prototype demand regulator and a doorknob. The doorknob, when pushed, inflated the lungs. The device could also be filled with medication, allowing the medicine to be easily inhaled.
A few months later, his friend’s father’s physician informed Bird that the patient was doing better than ever, and demanded that Bird make more of the breathing regulators for other patients. “We built thousands of those, and you can still find them out there,” Bird says. “That was what really got me thinking about being an inventor.”
Along came the Korean War, and Bird was assigned to aircrew evacuation, flying wounded soldiers home. This experience led him to invent the Bird Universal Medical Respirator, completed in 1955. The device was the first mass-produced respirator and assisted patients in need of acute and chronic pulmonary care. This respirator would later become crucial in Vietnam War air evacuations, saving the lives of soldiers with chest and lung injuries.
Before Bird’s respirator, wounded soldiers couldn’t be stabilized and treated until they reached the M.A.S.H. unit. With the respirator, “We could actually stabilize patients in flight,” Bird says.
And though he won’t take much credit for it, Bird and his respirator essentially invented MedEvac. “All I did was keep them alive long enough so that the surgeons could go in and do their corrective surgery and the pharmacological approaches could work and so on. All I do is make sure they don’t die first of pulmonary failure. So you see, we’re all a team.”
The Bird Respirator went international. “Interestingly, during the Cold War, the Russians and Chinese were among those military and civil institutions using my respirators,” Bird says. Currently, his respirators are used in 150 countries.
But the Bird Respirator could only be used on adults. So in 1970, Bird invented a pediatric respirator, nicknamed the BABYbird. Its fluffy nickname aside, the BABYbird is a serious device. It is estimated that this device single-handedly reduced mortality rates in infants with respiratory problems from 70 percent to less than 10 percent.
Bird was awarded the Lifetime Scientific Achievement Award in 1985, but his medical inventions and advances were far from over. Bird’s Intrapulmonary Percussive Ventilation (IPV) system, a forced breathing device, was invented in the 1980s. It reduced fatalities among severely burned patients with chemical inhalation injuries from over 60 percent to below 15 percent. It even saved his wife.
Bird’s wife, Mary, had pulmonary emphysema, and in 1980 an acute infection threatened to kill her.
“When Mary’s doctors said she was going to die, I got desperate,” Bird recalls. “She was almost comatose,” he remembers.
That desperation led him to take a prototype of the IPV, a project that he was still in the process of developing, and try it on his wife. It worked — two weeks later, Mary was up and about and driving her car. The experience sparked Bird to work on more respirators. “A lot of the devices I developed were because of Mary.”
Not all of those devices were for humans. Bird has saved the lives of all creatures great and small, from squirrels to elephants to blue-nosed dolphins. His respirators even helped keep the iconic killer whale, Shamu, alive during transport.
His V.I.P. Infant Pediatric System, the world’s only truly mobile ventilator, was invented just three years before Bird’s induction into the National Inventors Hall of Fame in 1995.
Bird was even the subject of a 2007 report on 60 Minutes. Now 88, Dr. Bird spends his time at his 300-acre home and aeromedical museum and research facility, Bird Space Technologies, in Sagle, Idaho. But he hasn’t slowed down a bit. He’s still flying search-and-rescue planes, still researching cardiopulmonary care, still educating doctors on the use of his respirators, and still inventing.
“It’s great working here,” Bird says. “We’re always trying to take and improve things and standardize. We’re a team.”
OTHER LOCAL MED-INVENTORS
Spokane orthodontist Dr. Dwight Damon created the Damon System, a new method for moving crooked teeth into alignment. First released in 1996, the Damon system features self-ligating brackets, which use the tension in a sliding wire to allow the braces to tighten and adjust themselves to some degree. The Damon brackets fit more snugly next to the tooth and have less friction to overcome than traditional brackets, meaning that the teeth can move faster and with much less force applied – a faster and less painful braces experience. The second version of the Damon bracket – the Damon 2 – is the most popular self-ligation system in the world.
Spokane surgeon Dr. Shane McNevin pioneered minimally invasive surgery – via mouth, anus, or small cuts rather than through a large incision. Thanks in part to him, patients no longer have to be sliced open for many procedures. McNevin has also proven in a study published by the American Journal of Surgery that laparoscopic surgery is “a viable alternative to open surgery,” even for the removal of something as large and difficult as a diseased whole colon. Laparoscopic surgery is a minimally invasive surgery that involves making small incisions in the abdomen, rather than the large incisions required in traditional surgical procedures. McNevin’s study is the largest of only five studies worldwide to consider the topic of laparoscopic removal of total colons and rectums.
Spokane, aside from road races and three-on-three basketball tournaments, is known for its cardiac care. Dr. Ralph Berg is one of the pioneers who helped build that repuatation. Berg performed the first open heart surgery in Spokane. The year was 1959, and open heart surgery was a dangerous and little-known undertaking. In fact, the first open-heart surgery in the nation had been performed just four years earlier. Berg assembled a group of medical professionals to help assist in the surgery, giving Spokane an open heart surgery team before 90 percent of the country’s medical schools had one. Thanks to Dr. Berg, Sacred Heart Medical Center became the seventh open-heart surgery center in the U.S., and the first one to exist outside of a major university.
